CN111067532A - Method and device for acquiring parameters of internal fixation system of fracture - Google Patents
Method and device for acquiring parameters of internal fixation system of fracture Download PDFInfo
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Abstract
The embodiment of the invention relates to a method for acquiring parameters of a fracture internal fixation system, which comprises the following steps: firstly, acquiring an unlabeled data set; secondly, generating a training sample set according to the unlabeled data set; then, training a pre-built parameter acquisition model by using a training sample set; then processing unknown medical record data according to the trained parameter acquisition model to obtain parameters of the fracture internal fixation system; and finally, determining the target width of the bent connecting rod and the target position of the bent connecting rod according to the obtained bridge length parameter and the preset bending radian of the bent connecting rod. The reasonable bridge length can control the stress of the fracture internal fixation system within a reasonable range, so that the strain generated by the fracture end is in a reasonable interval; on the basis of the reasonable bridge length, the target width and the target fixing position of the spiral bent connecting rod are further obtained by combining the preset bending radian, so that the micro-motion symmetry and the micro-motion quantity of the inner side and the outer side of the broken end of the skeleton accord with the corresponding preset range.
Description
Technical Field
The invention relates to the technical field of medical treatment, in particular to a method and a device for acquiring parameters of a fracture internal fixation system.
Background
Fracture healing modes mainly include direct healing and indirect healing. The direct healing (also called first-stage healing) refers to complete anatomical reduction of fracture sections, contact of the sections, no micromotion when the fracture ends are pressurized, and connection by direct growth of the haversian system of bones. The healing mode has no callus formation, is an unnatural fracture healing mode, is not firm enough in fracture healing, and has the risk of fracture after internal fixation after being taken out. Indirect healing (also called secondary healing) means that the fracture does not require complete anatomical reduction, and the protection of local blood circulation and the correctness of force lines are more important, so that the local part of the fracture end can generate micromotion to stimulate the formation of callus. The healing mode forms callus on local part, is a natural fracture healing mode, and has firm fracture healing.
Clinically, indirect healing is the primary direction of research and is the most common form of fracture healing in clinical practice. For indirect healing, local micromotion is one of the most critical factors. The fracture internal fixation systems such as a steel plate screw system, an intramedullary nail system and the like in clinic at present have certain problems, which are specifically shown as follows: when a single steel plate is used for fixation, eccentric stress can be generated (see figure 1a), and because the steel plate is only placed on one side of the skeleton, the micro-motion quantity generated on the opposite side of the steel plate of the stressed steel plate can be larger, and the micro-motion quantity on the side of the steel plate can be smaller. The great difference of the displacement micro-momentum inside and outside the fractured ends of the fracture can cause the callus on the opposite side of the steel plate to grow faster, the displacement callus on the same side of the steel plate to grow slower, and even the callus on the same side of the steel plate can not grow or even can be absorbed by bones due to the stress shielding effect.
It is considered to use double steel plate fixation to solve the above problems. From the mechanical analysis alone, even two-sided stress can be generated, but the supporting rigidity of the two steel plates is too large, and the fracture end hardly generates micro-momentum, so that the local callus growth is not favorable.
Therefore, how to design the structural parameters of the internal fracture fixation system to control the micromotion performance and improve the symmetry of the micromotion performance of the internal and external sides of the fracture is an urgent technical problem to be solved.
Disclosure of Invention
The invention aims to provide a method and a device for acquiring parameters of a fracture internal fixation system, aiming at the defects of the prior art, and the method and the device can be used for controlling the micromotion expression of the fracture end and improving the symmetry of the micromotion expression of the inner side and the outer side of the fracture end by acquiring the structural parameters of the fracture internal fixation system.
In view of the above, in a first aspect, an embodiment of the present invention provides a method for obtaining parameters of a fracture internal fixation system, where the fracture internal fixation system includes a straight connecting rod, a spiral bent connecting rod, and a plurality of fixing blocks for fixing the connecting rod to a bone;
the method comprises the following steps:
acquiring an unlabeled data set, wherein the unlabeled data set comprises at least one unlabeled sample, each unlabeled sample comprises patient information, parameter information of a fracture internal fixation system used by the patient and strain information, the patient information at least comprises patient weight and fracture gap data, the parameter information of the fracture internal fixation system used by the patient at least comprises bridge length, and the bridge length is the distance between fixed blocks which are respectively positioned at two sides of a fracture line and respectively closest to the fracture line;
generating a training sample set according to the unlabeled data set, wherein the training sample set comprises positive samples and negative samples with balanced quantity, the strain information corresponding to the positive samples belongs to a preset range, and the strain information corresponding to the negative samples does not belong to the preset range;
training a pre-established parameter acquisition model by using the training sample set, wherein training input is patient information and strain information corresponding to the training sample;
processing unknown medical record data according to the trained parameter acquisition model to obtain parameters of the fracture internal fixation system, wherein the unknown medical record data comprise patient information and target strain information, and the target strain information belongs to the preset range;
and determining the target width of the bent connecting rod and the target position of the bent connecting rod according to the bridge length parameter in the obtained parameters of the internal fracture fixation system and the preset bending radian of the bent connecting rod, wherein the target width and the target position are the width and the position which enable the micromotion symmetry of the inner side and the outer side of the broken end of the skeleton and the micromotion momentum of any side to accord with the corresponding preset range.
Preferably, the determining the target width of the curved connecting rod and the target position of the curved connecting rod according to the obtained bridge length parameter and the preset curved radian of the curved connecting rod in the parameters of the internal fixation system for bone fracture comprises:
keeping the bridge length parameter and the bending radian unchanged, obtaining the micro-motion quantity of the inner side and the outer side of the broken end of the skeleton under the conditions of different widths and/or different fixed positions through a mechanical experiment, and obtaining the micro-motion symmetry of the inner side and the outer side of the broken end of the skeleton according to the micro-motion quantity of the inner side and the outer side of the broken end of the skeleton;
and adjusting the width and/or the fixed position according to the micro momentum of the inner side and the outer side of the broken bone end obtained by experiments and the difference between the micro symmetry of the inner side and the outer side of the broken bone end and the corresponding preset range until the micro symmetry of the inner side and the outer side of the broken bone end and the micro momentum of any side conform to the corresponding preset range.
Preferably, the parameter information of the internal fracture fixation system further includes type information of the internal fracture fixation system, wherein at least one of the diameters of the connecting rods, the number of the fixing blocks, and the arrangement of the fixing blocks of different types of internal fracture fixation systems is different.
Preferably, the generating a training sample set according to an unlabeled data set includes:
for each unmarked sample in the unmarked data set, judging whether strain information corresponding to the unmarked sample belongs to a preset range;
if the strain information corresponding to the unlabeled sample belongs to a preset range, labeling the unlabeled sample as a positive sample;
if the strain information corresponding to the unlabeled sample does not belong to a preset range, labeling the unlabeled sample as a negative sample;
and respectively eliminating redundant samples in the positive sample and the negative sample to obtain a positive sample and a negative sample with balanced quantity.
Preferably, the training of the pre-established parameter acquisition model by using the training sample set includes:
for each positive sample or negative sample, converting patient information corresponding to the sample into a first feature vector, and converting strain information corresponding to the sample into a second feature vector;
splicing the first eigenvector and the second eigenvector to form an input matrix;
inputting the input matrix into the parameter acquisition model, and outputting a parameter predicted value;
and adjusting the parameter obtaining model according to the difference value between the output parameter predicted value and the parameter information corresponding to the sample until the parameter obtaining model meets the preset condition.
Further preferably, the processing unknown medical record data according to the trained parameter acquisition model to obtain parameters of the fracture internal fixation system includes:
converting patient information in the unknown medical record data into a third eigenvector, and converting the target strain information into a fourth eigenvector;
splicing the third eigenvector and the fourth eigenvector to obtain an input matrix;
and inputting the input matrix into the trained parameter acquisition model so that the parameter acquisition model outputs the parameters of the internal fracture fixation system.
Further preferably, the parameters of the internal fixation system for fracture output by the parameter acquisition model include the type of the internal fixation system for fracture that can be used by the patient and the bridge length parameters corresponding to the unknown medical record data.
Further preferably, the preset range is 2% -10%.
In a second aspect, the present application further provides a parameter acquisition device for a fracture internal fixation system, which comprises a straight connecting rod, a spiral bent connecting rod and a plurality of fixing blocks for fixing the connecting rod and a bone;
the device comprises:
the system comprises an acquisition module, a data processing module and a data processing module, wherein the acquisition module is used for acquiring an unlabeled data set, the unlabeled data set comprises at least one unlabeled sample, each unlabeled sample comprises patient information, parameter information of a fracture internal fixation system used by the patient and strain information, the patient information at least comprises patient weight and fracture gap data, the parameter information of the fracture internal fixation system used by the patient at least comprises bridge length, and the bridge length is the distance between fixed blocks which are respectively positioned at two sides of a fracture line and respectively closest to the fracture line;
the generating module is used for generating a training sample set according to the unlabeled data set, the training sample set comprises positive samples and negative samples which are balanced in quantity, the strain information corresponding to the positive samples belongs to a preset range, and the strain information corresponding to the negative samples does not belong to the preset range;
the training module is used for training a pre-established parameter acquisition model by using the training sample set, wherein training input is patient information and strain information corresponding to the training sample, and training output is parameter information of the fracture internal fixation system corresponding to the training sample;
the prediction module is used for processing unknown medical record data according to the trained parameter acquisition model to obtain parameters of the fracture internal fixation system, wherein the unknown medical record data comprises patient information and target strain information, and the target strain information belongs to the preset range;
and the simulation module is used for determining the target width of the bent connecting rod and the target position of the bent connecting rod according to the obtained bridge length parameter in the parameters of the internal fracture fixation system and the preset bending radian of the bent connecting rod, wherein the target width and the target position are the width and the position which enable the micromotion symmetry of the inner side and the outer side of the broken end of the skeleton and the micromotion momentum of any side to accord with the corresponding preset range.
The method and the device for acquiring the parameters of the internal fracture fixation system are based on the machine learning principle, a large number of medical data samples or medical simulation data samples are used for training to obtain a parameter acquisition model, and the parameter acquisition model is used for outputting reasonable bridge length parameters of the internal fracture fixation system according to patient information and target strain information. The reasonable bridge length can control the stress of the fracture internal fixation system within a reasonable range, namely the aim of controlling the stress of the fracture internal fixation system is fulfilled, so that the strain generated by the fracture end is in a reasonable interval; then, on the basis of the reasonable bridge length, the optimal width and the optimal fixing position of the spiral bent connecting rod are further obtained by combining a preset R radian, so that the micro-motion symmetry of the inner side and the outer side of the broken end of the skeleton and the micro-motion momentum of any side of the broken end of the skeleton accord with the corresponding preset range, and accurate and personalized internal fixation is realized.
Drawings
FIG. 1a is a schematic structural diagram of a bridge combined internal fixation system according to an embodiment of the present invention;
FIG. 1b is a schematic diagram of a bridge combined internal fixation system according to an embodiment of the present invention;
FIGS. 2a-7c are schematic structural diagrams of eight bridge combined internal fixation systems with different parameters according to an embodiment of the present invention;
FIG. 8 is a schematic structural view of a helically curved connecting rod according to an embodiment of the present invention;
FIG. 9 is a flowchart of a method for obtaining parameters of a fracture internal fixation system according to an embodiment of the present invention;
FIG. 10 is a schematic view of a fracture end face and a data acquisition method according to an embodiment of the present invention;
fig. 11 is a block diagram of a parameter obtaining device of a fracture internal fixation system according to an embodiment of the present invention.
Detailed Description
The technical solution of the present invention is further described in detail by the accompanying drawings and embodiments.
As mentioned in the background of the present application, the fracture end will generate micro-motion locally to stimulate the formation of callus, so the local micro-motion is one of the most critical factors affecting the indirect healing effect, and the structural parameters of the present clinical fracture internal fixation systems such as steel plate screw, intramedullary nail and bridge combination type directly affect the micro-motion.
Fig. 1 is a schematic structural diagram of a typical bridge combined internal fixation system, as shown in fig. 1, the bridge combined internal fixation system mainly includes:
the connecting rods 10, which may be threaded connecting rods, may be one or more in number. In addition, the connecting rod can be shaped straight or curved in different structural designs. The references to "connecting rod", "rod", etc. in the present application may refer to a straight connecting rod or to a curved connecting rod in different embodiments.
The fixing block 20 may further include a pressurizing fixing block and a locking fixing block according to the function of the fixing block, which will not be described herein. One or more through holes are formed in the fixing block, and the through holes can be used for being matched and fixed with the threaded connecting rods to form an internal fixing system or used for achieving reduction and fixation with the bone of a patient.
In the application, the local micromotion of the fracture end can be quantitatively characterized by strain. According to the Perren strain theory of fracture healing, the strain can be calculated by the following formula:
IFS＝IFM/L×100％
where IFS denotes strain, IFM denotes fracture fragment displacement, and L denotes fracture gap.
According to the Perren strain theory, the reasonable strain of the fracture gap is controlled to be between 2 and 10 percent, and the callus is difficult to grow due to insufficient stimulation below 2 percent; over 10 percent of the bone fracture parts can be unstably fixed and have over-large stimulation, and the bone nonunion is easy to happen.
In order to make the micro-motion amount of the inner and outer sides of the fracture end equal, i.e. the symmetry of the micro-motion expression of the inner and outer sides of the fracture meets the healing requirement, the micro-motion amount of the inner and outer sides of the fracture end needs to be controllable at first, even if the strain generated by the fracture end is in a reasonable interval, the symmetry of the micro-motion expression of the inner and outer sides of the fracture can be improved or ensured on the basis. Therefore, how to make the strain generated by the fracture end in a reasonable interval is the problem to be solved firstly.
In order to make the strain generated by the broken end of the fracture in a reasonable interval, precise and personalized internal fixation is required to be realized, namely, the stress of the bridging combined internal fixation system needs to be controlled within a reasonable range. For this reason, the inventor of the present application analyzes the factors affecting the local stress of the internal fixation system through finite element analysis and mechanical tests, wherein the possible influencing factors considered by the tests include: bridge length D, which is the distance between two fixed blocks (and screws) respectively located at two sides of the fracture line and respectively closest to the fracture line, as shown in FIG. 1; the diameter, number and arrangement of the connecting rods; and the quantity of the fixing blocks and the screws, hooks on the side and the like.
Referring to fig. 2a and 2b, the internal fixation system shown in fig. 2a is configured in accordance with a conventional steel plate system for baseline value reference; fig. 2b shows the internal fixation system in which the bridge length is shortened by a certain distance with respect to fig. 2 a. Test data show that when the bridge length is shortened by a certain distance, the axial micro-momentum of the fracture end is correspondingly reduced by a certain value, and the value of the micro-momentum can meet the requirement of changing in the range of clinical fracture healing micro-momentum.
Referring to fig. 3a and 3b, in the internal fixation system shown in fig. 3a, the bridge length is unchanged, and the first double-rod fixation block is replaced by a single-rod fixation block; test data show that the axial micro-motion amount of the broken end of the fracture is almost unchanged, so that the change of the form of the fixed block has almost no influence on the axial micro-motion, and the torsion resistance is improved; in the internal fixation system shown in fig. 3b, the bridge length is unchanged, the number of the secondary single-rod fixing blocks is increased, and test data show that the micromotion amount of the fracture end is almost unchanged, so that the change of the number of the fixing blocks has almost no influence on axial micromotion, and the torsion resistance is improved.
Referring to fig. 4a to 4d, in the internal fixation system shown in fig. 4a, the bridge length is unchanged, the secondary screw is replaced by the lock cap without the screw body, and experimental data show that the axial micromotion amount of the broken end of the fracture is almost unchanged, so that the replacement of the lock cap has almost no influence on the axial micromotion, and the anti-torsion performance is improved; FIG. 4b shows an internal fixation system in which the bridge length is shortened, the primary screw is replaced with a locking cap without a screw body, and experimental data show that the axial micro-motion amount of the fractured end is changed, so that the replacement of the locking cap has almost no influence on the axial micro-motion, the change of the bridge length is the primary influence factor, and the anti-torsion performance is improved; in the internal fixation system shown in fig. 4c, the bridge length is shortened, the secondary double-rod fixation block is replaced by a single-rod fixation block, and test data show that the axial micro-momentum change of the fracture end is realized, so that the change of the form of the fixation block hardly affects the axial micro-motion, the change of the bridge length is the primary influence factor, and the anti-torsion performance is improved; figure 4d shows an internal fixation system where the bridge length is shortened and the screw is placed in sliding engagement with the fixation block, and experimental data indicate that the amount of axial micromotion at the fracture end is increased, but torsional instability occurs locally, making this configuration unreasonable.
In addition, the inventor of the application also conducts a test aiming at the influence of the diameter of the connecting rod, and test data show that under the condition of unchanging bridge length, after the diameter of the single rod is increased by 2mm, the axial micromotion of the fracture end meets the range of clinical fracture healing micromotion; the diameter of the single rod is increased by 2mm and is molded into a spiral shape, the micromotion symmetry is improved, and the micromotion range of clinical fracture healing is met.
And (4) carrying out mechanical analysis on the real object according to the finite element analysis configuration, and displaying the result that the mechanical property of the real object accords with the result trend of the finite element analysis.
In summary, the primary factor affecting the local stress of the internal fixation system is bridge length; the secondary factors are the diameter, the number and the arrangement of the connecting rods, and due to the limitation of the practical clinical operation (mainly anatomical structures), the part of the factors can be determined into a plurality of configurations which accord with the practical clinical operation; for the quantity of the fixed blocks and the screws and hooks on the side, besides two fixed blocks influencing the bridge length, the influence of the position change and the quantity of other fixed blocks on the local strain of the fracture area is very small, and for safety considerations (such as preventing a slide rod, a rotating rod and the like), the single-rod structure needs to keep 2-4 fixed blocks and screws on two sides of the fracture line, and the double-rod structure needs to ensure 3-5 fixed blocks and screws.
Therefore, under the condition that the number and the arrangement of the connecting rods are clinically and preliminarily determined under the conditions of the secondary variable factors (the diameters, the number and the arrangement of the connecting rods) and other variable factors (the number of the fixing blocks and the screws and hooks on the side portions), the stress of the bridge-connection combined type internal fixing system can be controlled within a reasonable range by reasonable bridge length, and therefore the strain generated by the fracture broken end is in a reasonable interval.
Under the condition that the strain generated by the fracture end can be in a reasonable interval, how to improve or ensure the symmetry of the micromotion expressions on the inner side and the outer side of the fracture end becomes the technical problem to be solved next.
In order to make the bridge-connection combined internal fixation system have reasonable elasticity so as to make the stress on the inner side and the outer side of the fracture end balanced, the inventor researches the relation between the spatial arrangement of the internal fixation system and the symmetry of micromotion.
Referring to fig. 5a-5d, under the condition of keeping the bridge length unchanged, the combined bridging internal fixation system shown in fig. 5a replaces a double-rod structure with a double straight single rod arranged at 180 degrees, and experimental data show that the micromotion symmetry of the inner side and the outer side of the fracture end is improved, but the axial micromotion of the fracture end is too small and is lower than the reasonable range of clinical fracture healing micromotion, so that the configuration is unreasonable for comminuted fractures; FIG. 5b shows a combined bridging internal fixation system that adjusts one single rod of a double straight single rod structure to have an outward convex radian, and experimental data shows that the micromotion symmetry of the inner and outer sides of the fractured end is improved, but the axial micromotion of the fractured end is too small to be within a reasonable range of clinical fracture healing micromotion, so that the configuration is unreasonable for comminuted fractures; FIG. 5c shows a combined bridging internal fixation system that adjusts both single rods of a double straight single rod structure to have outward convex radians, and experimental data shows that the micromotion symmetry of the inner and outer sides of the fractured end is improved, but the axial micromotion of the fractured end is too small to be within a reasonable range of clinical fracture healing micromotion, so the configuration is unreasonable for comminuted fractures; the combined bridging internal fixation system shown in fig. 5d adjusts the double-arc single-rod structure with 180 degrees of arrangement into 90 degrees of arrangement, and test data shows that the micromotion symmetry of the inner side and the outer side of the fracture end is improved, but the axial micromotion amount of the fracture end is too small and is lower than the reasonable range of clinical fracture healing micromotion amount, so that the configuration is unreasonable for comminuted fracture.
Referring to fig. 6a to 6e, under the condition of keeping the bridge length unchanged, the combined bridge internal fixation system shown in fig. 6a replaces the double rods with the small spiral single rod, and experimental data show that the axial micromotion of the fracture end meets the range of the clinical fracture healing micromotion, the micromotion in the shearing direction is large, and the shearing micromotion needs to be controlled by improvement; the combined bridging internal fixing system shown in fig. 6b adjusts the small spiral single rod structure into a large spiral single rod, and experimental data show that the axial micro-momentum of the fracture end meets the range of the clinical fracture healing micro-momentum, the micro-momentum in the shearing direction is large, and the shearing micro-momentum needs to be controlled by improvement; the combined bridging internal fixation system shown in fig. 6c adjusts the large spiral single rod structure into a large spiral double rod structure, and experimental data show that the axial micromotion of the fracture end meets the range of the clinical fracture healing micromotion, the micromotion symmetry is improved, the micromotion in the shearing direction is large, and the shearing micromotion needs to be controlled by improvement; the combined bridging internal fixation system shown in fig. 6d adjusts the large spiral double rods into one side double straight rods, and experimental data show that the axial micromotion of the fracture end meets the range of the clinical fracture healing micromotion, the shear direction micromotion is controlled, and the micromotion symmetry is improved; the combined bridging internal fixation system shown in fig. 6e adjusts the large spiral double rods into a single straight rod on one side, and experimental data show that the axial micromotion of the fracture end meets the range of the clinical fracture healing micromotion, the shear direction micromotion is controlled, and the micromotion symmetry is improved
Referring to fig. 7a and 7b, under the condition of keeping the bridge length unchanged, the combined bridging internal fixation system shown in fig. 7a replaces the double rods with the triple rods, and experimental data show that the micromotion symmetry is improved, but the axial micromotion amount of the fracture end is too small and is lower than the range of clinical fracture healing micromotion amount, so that the configuration is unreasonable for comminuted fracture; figure 7b shows a modular bridging internal fixation system with two rods replaced with three rods and one rod reduced in diameter, experimental data showing improved micromotion symmetry but with a fracture end having too little axial micromotion to fit within the range of clinical fracture healing micromotion, and therefore this configuration is not reasonable for comminuted fractures. Referring to fig. 7c, the combined bridging internal fixation system shown in fig. 7a shortens the bridge length and replaces the double rods with three rods, experimental data show that the micromotion symmetry is improved, but the axial micromotion amount at the fracture end is too small to be within the range of the clinical fracture healing micromotion amount, and therefore the configuration is not reasonable for comminuted fractures.
In addition, under the condition of keeping the bridge length unchanged, the inventor replaces three rods with a double rod and a single rod on one side for overhead, test data shows that the micromotion symmetry is improved, and the axial micromotion of the fracture end meets the range of clinical fracture healing micromotion; the double rods are replaced by a straight rod on one side and a single rod on one side, and test data show that the micromotion symmetry is improved, and the micromotion range of clinical fracture healing is met; and the double rods are replaced by a spiral rod at one side and a single rod at one side for overhead, and test data show that the micromotion symmetry is improved, so that the micromotion range of clinical fracture healing is met.
According to the test results, the inventor carries out design improvement on the bridge-connection combined type internal fixing system, and shapes the connecting rod on one side into a spiral shape, so that the elasticity and the torsion resistance of the system are improved.
Fig. 8 is a schematic structural diagram of a spiral-shaped bent connecting rod according to an embodiment of the present disclosure, and as can be seen from fig. 8, shape parameters of the spiral-shaped bent connecting rod mainly include a width, a height, and a bending arc (R arc), where the height is limited by a bridge length. Therefore, the width and the R radian of the spiral bent connecting rod and the space arrangement relationship between the spiral bent connecting rod and the other straight connecting rod become main factors influencing the elasticity and the torsion resistance of the bridge combined type internal fixation system, and further become main factors influencing the micro-motion symmetry of the inner side and the outer side of the fracture end.
For the R radian, a first R radian (or called optimal R radian) which enables the safety of the system structure to be highest can be obtained through limited experiments, and a second R radian (or called minimum R radian) which enables the elasticity of the system structure to be optimal can also be obtained.
Based on the above, in order to improve the micro-motion symmetry of the inner side and the outer side of the fracture end, under the condition of obtaining the length of the fixed bridge, the optimal R radian and the minimum R radian, the width and the fixed position (the space arrangement relation between the spiral bent connecting rod and another straight connecting rod) of the spiral bent connecting rod can be adjusted through experiments, and then the optimal width and the optimal fixed position which can meet the requirement of the micro-motion symmetry are obtained.
Based on the theoretical research, the application provides a method for acquiring parameters of a fracture internal fixation system, which can firstly acquire a reasonable bridge length, further enable the axial micromotion of the fracture end to meet the reasonable range of healing requirements, and then further acquire the optimal width and the optimal fixing position of the spiral bent connecting rod by combining with a preset R radian (the optimal R radian or the minimum R radian) on the basis of the reasonable bridge length. Fig. 9 is a flowchart of a method for acquiring parameters of a fracture internal fixation system provided by the present application, and as shown in fig. 9, the method may include:
Acquiring N unlabeled samples from unlabeled historical medical scheme data or medical simulation experiment data to form N unlabeled data sets with the size, wherein each unlabeled sample comprises patient information and parameter information and strain information of a fracture internal fixation system used by the patient. The patient information at least comprises the weight of the patient, and of course, in order to improve the information enrichment degree of the sample, the patient information can also comprise three-dimensional model data of broken bones of the patient, the sex of the patient, the age of the patient and the like; the parameter information of the internal fracture fixation system used by the patient at least comprises bridge length data adopted by the internal fracture fixation system, and also can comprise type information of the internal fracture fixation system used by the patient, the diameter, the number and the arrangement mode of the type information connecting rods, the number and the arrangement mode of the fixed blocks and the like, or at least one of the diameter, the number and the arrangement mode of the connecting rods of the internal fracture fixation systems of different types, and the number and the arrangement mode of the fixed blocks is different.
In addition, the strain information can be the stress information of the internal fixation system, and can also be the strain information of the fracture end of the patient, and the two have a correlation relationship.
And 120, generating a training sample set according to the unlabeled data set, wherein the training sample set comprises positive samples and negative samples with balanced quantity, the strain information corresponding to the positive samples belongs to a preset range, and the strain information corresponding to the negative samples does not belong to the preset range.
Firstly, labeling each unlabeled sample in the unlabeled data set, wherein the labeling method comprises the steps of judging whether strain information corresponding to each unlabeled sample belongs to a preset range, labeling the sample as a positive sample if the strain information belongs to the preset range, and labeling the sample as a negative sample if the strain information does not belong to the preset range. Wherein the preset range is a reasonable range of strain generated by the fracture broken end in the indirect healing process, such as 2% -10% suggested by Perren strain theory.
Secondly, respectively providing redundant samples in the positive samples and redundant samples in the negative samples, and eliminating the redundant samples, wherein the purpose of eliminating the redundant samples is to balance the quantity of the positive samples and the quantity of the negative samples in the training sample set, to make the distribution of the negative samples uniform (the distribution of strain information corresponding to a plurality of negative samples is uniform), and to make the distribution of the positive samples uniform (the distribution of strain information corresponding to a plurality of positive samples is uniform), so that the generalization of the parameter acquisition model is improved.
After the redundant samples are eliminated, the remaining positive samples and negative samples form a training sample set, for example, the training sample set includes M training samples, where the ratio of the positive samples to the negative samples is 1:1, and M is smaller than N.
In addition, a test sample set is generated according to the eliminated redundant samples and is used for testing the parameter acquisition model.
And step 130, training a pre-established parameter acquisition model by using the training sample set, wherein training input is patient information and strain information corresponding to the training sample, and training output is parameter information of the fracture internal fixation system corresponding to the training sample.
In the application, the pre-established parameter acquisition model may be a neural network model, such as a logistic regression model. And in the optimization process, the model parameters gradually learn the mathematical relationship among the patient information, the strain information and the parameter information of the fracture internal fixation system, so that after the optimization is completed, the patient information and the strain information are given, and the parameter acquisition model can output uniquely determined bridge length data.
In step 130, the sample data is first converted into data recognizable to the computer. Specifically, the method comprises the following steps: for each positive sample or negative sample, converting patient information corresponding to the sample into a first feature vector, and converting strain information corresponding to the sample into a second feature vector; splicing the first eigenvector and the second eigenvector to form an input matrix; inputting the input matrix into a parameter acquisition model, and outputting a parameter predicted value, wherein the parameter predicted value can be a bridge length predicted value; and adjusting the parameter obtaining model according to a difference between the output parameter predicted value and the parameter information corresponding to the sample, specifically, a difference between the bridge length predicted value and the bridge length data corresponding to the sample, until the parameter obtaining model meets a preset condition, where the preset condition may be a threshold set for the accuracy of the parameter obtaining model. Wherein, the accuracy of the parameter obtaining model can be obtained by using the test sample set.
And 140, processing unknown medical record data according to the trained parameter acquisition model to obtain parameters of the fracture internal fixation system, wherein the unknown medical record data comprises patient information and target strain information, and the target strain information belongs to the preset range.
In step 140, the unknown medical record data is first converted into data that can be recognized by a computer. Specifically, the method comprises the following steps: converting patient information in the unknown medical record data into a third eigenvector, and converting the target strain information into a fourth eigenvector; splicing the third eigenvector and the fourth eigenvector to obtain an input matrix; and inputting the input matrix into the trained parameter acquisition model so that the parameter acquisition model outputs parameters of the internal fracture fixation system.
It should be noted that the parameters of the internal fixation system for fracture output by the parameter obtaining model include the bridge length data that can be used by the patient to which the unknown medical record data belongs, and may also include the type of the internal fixation system for fracture that can be used by the patient to which the unknown medical record data belongs.
And 150, determining the target width of the bent connecting rod and the target position of the bent connecting rod according to the bridge length parameter in the obtained parameters of the internal fracture fixation system and the preset bending radian of the bent connecting rod, wherein the target width and the target position are the width and the position which enable the micromotion symmetry of the inner side and the outer side of the broken end of the skeleton and the micromotion momentum of any side to accord with the corresponding preset range.
The preset bending radian of the bending connecting rod can be the minimum R radian or the optimal R radian.
In some embodiments, determining the target width of the curved connecting rod and the target position of the curved connecting rod according to the bridge length parameter and the preset curvature of the curved connecting rod in the obtained parameters of the internal fixation system for fracture comprises:
firstly, the bridge length and the preset curvature obtained in the step 140 are adopted, the bridge length and the curvature are kept unchanged, the micro-motion quantities of the inner side and the outer side of the broken end of the skeleton under the conditions of different widths and/or different fixed positions are obtained through a mechanical experiment, and the micro-motion symmetry of the inner side and the outer side of the broken end of the skeleton is obtained according to the micro-motion quantities of the inner side and the outer side of the broken end of the skeleton. For example, the micro symmetry is characterized by the ratio of micro momentum of the inner side and the outer side of the broken end of the bone, and the application is not limited.
Then, according to the micro momentum of the inner side and the outer side of the broken end of the skeleton obtained by the experiment and the difference value between the micro symmetry of the inner side and the outer side of the broken end of the skeleton and the corresponding preset range, the width and/or the fixed position are adjusted, and the experiment is repeated until the micro symmetry of the inner side and the outer side of the broken end of the skeleton and the micro momentum of any side of the broken end of the skeleton accord with the corresponding preset range. The corresponding predetermined range comprises a predetermined range corresponding to the micromotion symmetry and a predetermined range corresponding to the micromotion, and the predetermined range corresponding to the micromotion can be the same as the preset range of the strain information.
It should be noted that, as shown in fig. 10, in the experimental process, displacement data of 8 points of the fracture end surface in the X, Y, Z direction may be collected by an optical measurement instrument, and the micromovements of the inner side and the outer side of the fracture end of the bone may be respectively calculated, so as to calculate the symmetry micromoveability.
The invention provides a method for acquiring parameters of a fracture internal fixation system, which is based on a machine learning principle and is trained by using a large number of medical data samples or medical simulation data samples to obtain a parameter acquisition model, wherein the parameter acquisition model is used for outputting reasonable bridge length parameters of the fracture internal fixation system according to patient information and target strain information. The reasonable bridge length can control the stress of the fracture internal fixation system within a reasonable range, namely the aim of controlling the stress of the fracture internal fixation system is fulfilled, so that the strain generated by the fracture end is in a reasonable interval; then, on the basis of the reasonable bridge length, the optimal width and the optimal fixing position of the spiral bent connecting rod are further obtained by combining a preset R radian (the optimal R radian or the minimum R radian), so that the micromotion symmetry of the inner side and the outer side of the broken end of the skeleton and the micromotion momentum of any side of the broken end of the skeleton accord with the corresponding preset range, and accurate and personalized internal fixation is realized.
According to the method for acquiring parameters of the internal fixation system for fracture provided by the above embodiment, an embodiment of the present application further provides an apparatus for acquiring parameters of an internal fixation system for fracture, as shown in fig. 11, the apparatus may include:
an obtaining module 100, configured to obtain an unlabeled data set, where the unlabeled data set includes at least one unlabeled sample, each unlabeled sample includes patient information, parameter information of a fracture internal fixation system used by the patient, and strain information, the patient information includes at least patient weight and fracture gap data, the parameter information of the fracture internal fixation system used by the patient includes at least a bridge length, and the bridge length is a distance between fixed blocks that are located on two sides of a fracture line and are respectively closest to the fracture line;
a generating module 200, configured to generate a training sample set according to the unlabeled data set, where the training sample set includes positive samples and negative samples with balanced quantities, where strain information corresponding to the positive samples belongs to a preset range, and strain information corresponding to the negative samples does not belong to the preset range;
the training module 300 is configured to train a pre-established parameter acquisition model by using the training sample set, where training input is patient information and strain information corresponding to the training sample, and training output is parameter information of the internal fracture fixation system corresponding to the training sample;
the prediction module 400 is configured to process unknown medical record data according to the trained parameter acquisition model to obtain parameters of the fracture internal fixation system, where the unknown medical record data includes patient information and target strain information, and the target strain information belongs to the preset range;
and the simulation module 500 is configured to determine a target width of the bent connecting rod and a target position of the bent connecting rod according to a bridge length parameter in the obtained parameters of the internal fixation system for fracture and a preset bending radian of the bent connecting rod, where the target width and the target position are widths and positions at which micro-motion symmetry at the inner side and the outer side of the broken end of the bone and micro-motion momentum at any side of the broken end of the bone meet corresponding preset ranges.
In some embodiments, the generating module 200 is specifically configured to, for each unlabeled sample in the unlabeled dataset, determine whether strain information corresponding to the unlabeled sample belongs to a preset range; if the strain information corresponding to the unlabeled sample belongs to a preset range, labeling the unlabeled sample as a positive sample; if the strain information corresponding to the unlabeled sample does not belong to a preset range, labeling the unlabeled sample as a negative sample; and respectively eliminating redundant samples in the positive sample and the negative sample to obtain a positive sample and a negative sample with balanced quantity.
In some embodiments, the training module 300 is specifically configured to, for each of the positive case samples or the negative case samples, convert patient information corresponding to the sample into a first feature vector, and convert strain information corresponding to the sample into a second feature vector; splicing the first eigenvector and the second eigenvector to form an input matrix; inputting the input matrix into the parameter acquisition model, and outputting a parameter predicted value; and adjusting the parameter obtaining model according to the difference value between the output parameter predicted value and the parameter information corresponding to the sample until the parameter obtaining model meets the preset condition.
In some embodiments, the prediction module 400 is specifically configured to convert patient information in the unknown medical record data into a third feature vector and convert the target strain information into a fourth feature vector; splicing the third eigenvector and the fourth eigenvector to obtain an input matrix; and inputting the input matrix into the trained parameter acquisition model so that the parameter acquisition model outputs the parameters of the internal fracture fixation system.
In some embodiments, the simulation module 500 is specifically configured to keep the bridge length parameter and the bending radian unchanged, obtain micro-motion quantities of the inner side and the outer side of the broken end of the bone under the conditions of different widths and/or different fixed positions through a mechanical experiment, and obtain micro-motion symmetry of the inner side and the outer side of the broken end of the bone according to the micro-motion quantities of the inner side and the outer side of the broken end of the bone; and adjusting the width and/or the fixed position according to the micro momentum of the inner side and the outer side of the broken bone end obtained by experiments and the difference between the micro symmetry of the inner side and the outer side of the broken bone end and the corresponding preset range until the micro symmetry of the inner side and the outer side of the broken bone end and the micro momentum of any side conform to the corresponding preset range.
Those of skill would further appreciate that the various illustrative components and algorithm steps described in connection with the embodiments disclosed herein may be implemented as electronic hardware, computer software, or combinations of both, and that the various illustrative components and steps have been described above generally in terms of their functionality in order to clearly illustrate this interchangeability of hardware and software. Whether such functionality is implemented as hardware or software depends upon the particular application and design constraints imposed on the implementation. Skilled artisans may implement the described functionality in varying ways for each particular application, but such implementation decisions should not be interpreted as causing a departure from the scope of the present invention.
The steps of a method or algorithm described in connection with the embodiments disclosed herein may be embodied in hardware, a software module executed by a processor, or a combination of the two. A software module may reside in Random Access Memory (RAM), memory, Read Only Memory (ROM), electrically programmable ROM, electrically erasable programmable ROM, registers, hard disk, a removable disk, a CD-ROM, or any other form of storage medium known in the art.
The above-mentioned embodiments are intended to illustrate the objects, technical solutions and advantages of the present invention in further detail, and it should be understood that the above-mentioned embodiments are merely exemplary embodiments of the present invention, and are not intended to limit the scope of the present invention, and any modifications, equivalent substitutions, improvements and the like made within the spirit and principle of the present invention should be included in the scope of the present invention.
Claims (9)
1. A method for acquiring parameters of a fracture internal fixation system is characterized in that the fracture internal fixation system comprises a straight connecting rod, a spiral bent connecting rod and a plurality of fixing blocks for fixing the connecting rod and a skeleton;
the method comprises the following steps:
acquiring an unlabeled data set, wherein the unlabeled data set comprises at least one unlabeled sample, each unlabeled sample comprises patient information, parameter information of a fracture internal fixation system used by the patient and strain information, the patient information at least comprises patient weight and fracture gap data, the parameter information of the fracture internal fixation system used by the patient at least comprises bridge length, and the bridge length is the distance between fixed blocks which are respectively positioned at two sides of a fracture line and respectively closest to the fracture line;
generating a training sample set according to the unlabeled data set, wherein the training sample set comprises positive samples and negative samples with balanced quantity, the strain information corresponding to the positive samples belongs to a preset range, and the strain information corresponding to the negative samples does not belong to the preset range;
training a pre-established parameter acquisition model by using the training sample set, wherein training input is patient information and strain information corresponding to the training sample;
processing unknown medical record data according to the trained parameter acquisition model to obtain parameters of the fracture internal fixation system, wherein the unknown medical record data comprise patient information and target strain information, and the target strain information belongs to the preset range;
and determining the target width of the bent connecting rod and the target position of the bent connecting rod according to the bridge length parameter in the obtained parameters of the internal fracture fixation system and the preset bending radian of the bent connecting rod, wherein the target width and the target position are the width and the position which enable the micromotion symmetry of the inner side and the outer side of the broken end of the skeleton and the micromotion momentum of any side to accord with the corresponding preset range.
2. The method for acquiring parameters of an internal fixation system for bone fracture according to claim 1, wherein the determining the target width of the curved connecting rod and the target position of the curved connecting rod according to the obtained parameters of the internal fixation system for bone fracture and the preset curved radian of the curved connecting rod comprises:
keeping the bridge length parameter and the bending radian unchanged, obtaining the micro-motion quantity of the inner side and the outer side of the broken end of the skeleton under the conditions of different widths and/or different fixed positions through a mechanical experiment, and obtaining the micro-motion symmetry of the inner side and the outer side of the broken end of the skeleton according to the micro-motion quantity of the inner side and the outer side of the broken end of the skeleton;
and adjusting the width and/or the fixed position according to the micro momentum of the inner side and the outer side of the broken bone end obtained by experiments and the difference between the micro symmetry of the inner side and the outer side of the broken bone end and the corresponding preset range until the micro symmetry of the inner side and the outer side of the broken bone end and the micro momentum of any side conform to the corresponding preset range.
3. The method for acquiring parameters of an internal fixation system for bone fracture according to claim 1, wherein the parameters information of the internal fixation system for bone fracture further comprises type information of the internal fixation system for bone fracture, wherein at least one of the diameter of the connecting rod, the number of the fixing blocks, and the arrangement of the fixing blocks of different types of the internal fixation system for bone fracture is different.
4. The method for obtaining parameters of an internal fixation system for bone fracture according to claim 1, wherein the generating a training sample set according to an unlabeled data set comprises:
for each unmarked sample in the unmarked data set, judging whether strain information corresponding to the unmarked sample belongs to a preset range;
if the strain information corresponding to the unlabeled sample belongs to a preset range, labeling the unlabeled sample as a positive sample;
if the strain information corresponding to the unlabeled sample does not belong to a preset range, labeling the unlabeled sample as a negative sample;
and respectively eliminating redundant samples in the positive sample and the negative sample to obtain a positive sample and a negative sample with balanced quantity.
5. The method for acquiring parameters of a bone fracture internal fixation system according to claim 1, wherein the training of the pre-built parameter acquisition model by using the training sample set comprises:
for each positive sample or negative sample, converting patient information corresponding to the sample into a first feature vector, and converting strain information corresponding to the sample into a second feature vector;
splicing the first eigenvector and the second eigenvector to form an input matrix;
inputting the input matrix into the parameter acquisition model, and outputting a parameter predicted value;
and adjusting the parameter obtaining model according to the difference value between the output parameter predicted value and the parameter information corresponding to the sample until the parameter obtaining model meets the preset condition.
6. The method for acquiring parameters of an internal fixation system for bone fracture according to claim 1, wherein the processing of unknown medical record data according to the trained parameter acquisition model to acquire parameters of the internal fixation system for bone fracture comprises:
converting patient information in the unknown medical record data into a third eigenvector, and converting the target strain information into a fourth eigenvector;
splicing the third eigenvector and the fourth eigenvector to obtain an input matrix;
and inputting the input matrix into the trained parameter acquisition model so that the parameter acquisition model outputs the parameters of the internal fracture fixation system.
7. The method for acquiring parameters of an internal fixation system for bone fracture according to claim 3, wherein the parameters of the internal fixation system for bone fracture output by the parameter acquisition model include the type of internal fixation system for bone fracture and the bridge length parameter applicable to the patient corresponding to the unknown medical record data.
8. The method for obtaining parameters of an internal fixation system for bone fracture as claimed in any one of claims 1 to 7, wherein said predetermined range is 2% to 10%.
9. A parameter acquisition device of a fracture internal fixation system is characterized in that the fracture internal fixation system comprises a straight connecting rod, a spiral bent connecting rod and a plurality of fixing blocks for fixing the connecting rod and a skeleton;
the device comprises:
the system comprises an acquisition module, a data processing module and a data processing module, wherein the acquisition module is used for acquiring an unlabeled data set, the unlabeled data set comprises at least one unlabeled sample, each unlabeled sample comprises patient information, parameter information of a fracture internal fixation system used by the patient and strain information, the patient information at least comprises patient weight and fracture gap data, the parameter information of the fracture internal fixation system used by the patient at least comprises bridge length, and the bridge length is the distance between fixed blocks which are respectively positioned at two sides of a fracture line and respectively closest to the fracture line;
the generating module is used for generating a training sample set according to the unlabeled data set, the training sample set comprises positive samples and negative samples which are balanced in quantity, the strain information corresponding to the positive samples belongs to a preset range, and the strain information corresponding to the negative samples does not belong to the preset range;
the training module is used for training a pre-established parameter acquisition model by using the training sample set, wherein training input is patient information and strain information corresponding to the training sample, and training output is parameter information of the fracture internal fixation system corresponding to the training sample;
the prediction module is used for processing unknown medical record data according to the trained parameter acquisition model to obtain parameters of the fracture internal fixation system, wherein the unknown medical record data comprises patient information and target strain information, and the target strain information belongs to the preset range;
and the simulation module is used for determining the target width of the bent connecting rod and the target position of the bent connecting rod according to the obtained bridge length parameter in the parameters of the internal fracture fixation system and the preset bending radian of the bent connecting rod, wherein the target width and the target position are the width and the position which enable the micromotion symmetry of the inner side and the outer side of the broken end of the skeleton and the micromotion momentum of any side to accord with the corresponding preset range.
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